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Do holding exercises or antimuscarinics increase maximum voided volume in monosymptomatic nocturnal enuresis? A

Koen J Van Hoeck1, An Bael, Els Van Dessel

  • 1Department of Pediatrics, University Hospital Antwerp, Antwerp, Belgium. koen.van.hoeck@uza.be

The Journal of Urology
|September 18, 2007
PubMed

Insights

Holding exercises effectively increase bladder capacity in children with nocturnal enuresis. However, this increase in maximum voided volume showed minimal impact on the overall treatment of monosymptomatic nocturnal enuresis compared to alarm therapy.

Area of Science:

  • Pediatric Urology
  • Child Health
  • Urodynamics

Background:

  • Monosymptomatic nocturnal enuresis (MNE) is common in children.
  • Limited bladder capacity, indicated by low maximum voided volume (MVV), is a key factor in MNE.
  • Effective treatment strategies to increase MVV are needed.

Purpose of the Study:

  • To evaluate the efficacy of holding exercises and antimuscarinics (oxybutynin chloride) in increasing MVV in children with MNE.
  • To compare the effects of these interventions with placebo and alarm therapy.

Main Methods:

  • A prospective randomized study involving 149 children with MNE.
  • Five groups were formed: holding exercises with placebo, holding exercises with oxybutynin, placebo alone, oxybutynin alone, and alarm treatment (controls).
  • Interventions were administered for 12 weeks, with MVV assessed via bladder diaries and holding exercise volume measured after fluid loading.

Main Results:

  • Holding exercises, with or without oxybutynin, significantly increased both holding exercise volume and MVV.
  • Oxybutynin alone or with placebo did not significantly increase MVV.
  • While holding exercises improved bladder capacity, the response rate for MNE was significantly lower (7%) compared to alarm therapy (73%).

Conclusions:

  • Holding exercises can significantly increase maximum voided volume in children with MNE.
  • Oxybutynin chloride alone is not effective for increasing MVV in this population.
  • Increasing MVV through holding exercises has a minimal effect on the overall resolution of MNE compared to established treatments like alarm therapy.
Abstract

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